| Pure Waves Counseling Llc | |
|
1476 Kenwood Dr Ste 102 Menasha WI 54952-1134 | |
| (920) 376-8920 | |
| Not Available |
| Full Name | Pure Waves Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1476 Kenwood Dr Ste 102, Menasha, Wisconsin |
| Authorized Official Name and Position | Ashley Ann Matthies (OWNER) |
| Authorized Official Contact | 9203768920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Waves Counseling Llc W5820 Delta Dr Menasha WI 54952-4400 Ph: (920) 376-8920 | Pure Waves Counseling Llc 1476 Kenwood Dr Ste 102 Menasha WI 54952-1134 Ph: (920) 376-8920 |
| NPI Number | 1235028408 |
|---|---|
| Provider Enumeration Date | 07/01/2025 |
| Last Update Date | 07/01/2025 |
| Certification Date | 06/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235028408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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